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Management of IgE-Mediated Food Allergy in the 21st Century

Cafarotti, Arianna, Giovannini, Mattia, Begìn, Philippe, Brough, Helen A., Arasi, Stefania·2023·Clinical & Experimental Allergy
DOI 10.1111/cea.14241PMC PMC10092460
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Abstract

The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach. Allergen immunotherapy has been recommended for the active management of food allergy. Data have shown promising additional methods of treatment, including biologics. Efforts have been devoted to the risk stratification of food allergy and the standardization of the assessment of food‐allergic severity. Alternative routes of administration of epinephrine are under investigation to minimize any mechanical issue and the fear of injections. Evidence‐based guidelines have been published by the main international societies in the field of anaphylaxis and food allergy management and new updates are in preparation. In the coming years, treatment options that are currently in pre‐clinical or early clinical evaluation will hopefully lead to safe and effective disease‐modifying therapies for food allergy in clinical practice. The identification of reliable biomarkers and the standardization of definitions and measurement approaches, alongside a shared decision‐making with patients and families, will be key for the development of personalized care and to help minimize the substantial burden of food allergy.

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FIGURE 1 Multidisciplinary integrated care in food allergy—adapted from EAACI guidelines for the management of patients with allergies. 119
FIGURE 1 Multidisciplinary integrated care in food allergy—adapted from EAACI guidelines for the management of patients with allergies. 119CC BY-NC-ND · PubMed Central
FIGURE 2 Milestones in the management of food allergy in the 21st century. DBPCFC, double‐blind placebo‐controlled food challenge; DRACMA, Diagnosis and Rationale for Action against Cow's Milk Allergy; EMS, Emergency Medical Services; EAACI, European Academy of Allergy and Clinical Immunology; FA, food allergy; FAQLQ, Food Allergy Quality of Life Questionnaires; FA‐HRQL, Food Allergy Health Related Quality of Life; FDA, Food and Drug Administration; HRQL, Health Related Quality of Life; OFC, oral food challenge; OIT, oral immunotherapy; OMA, omalizumab; PANAS, Positive and Negative Affect Schedule; pts, patients; POIT, peanut oral immunotherapy; SU, sustained unresponsiveness.
FIGURE 2 Milestones in the management of food allergy in the 21st century. DBPCFC, double‐blind placebo‐controlled food challenge; DRACMA, Diagnosis and Rationale for Action against Cow's Milk Allergy; EMS, Emergency Medical Services; EAACI, European Academy of Allergy and Clinical Immunology; FA, food allergy; FAQLQ, Food Allergy Quality of Life Questionnaires; FA‐HRQL, Food Allergy Health Related Quality of Life; FDA, Food and Drug Administration; HRQL, Health Related Quality of Life; OFC, oral food challenge; OIT, oral immunotherapy; OMA, omalizumab; PANAS, Positive and Negative Affect Schedule; pts, patients; POIT, peanut oral immunotherapy; SU, sustained unresponsiveness.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Cafarotti, A., Giovannini, M., Begìn, P., Brough, H. A., & Arasi, S.
Affiliations
  • Allergy Unit ‐ Area of Translational Research in Pediatric Specialities Bambino Gesù Children's Hospital, IRCCS Rome Italy
  • Allergy Unit, Department of Pediatrics Meyer Children's University Hospital Florence Italy
  • Allergy, Immunology and Rheumatology Division, Department of Pediatrics CHU Sainte‐Justine Montreal Quebec Canada
  • Children's Allergy Service, Evelina Children's Hospital Guy's and St. Thomas' NHS Foundation Hospital London UK
ORCID
Venue
Clinical & Experimental Allergy
Publisher
Wiley
Published
2022-10-19
Volume
53
Issue
1
Pages
25-38
ISSN
  • 0954-7894
  • 1365-2222
DOI
10.1111/cea.14241
PMC
PMC10092460
Cited by
34
References
1
Language
en
Licence
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)

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